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Understanding Foot and Ankle Fractures in Older Women

Posted on: 11/30/1999
Older women often suffer foot and ankle fractures. Doctors usually assume that these fractures are caused by osteoporosis. However, there has been little research into the cause of foot and ankle fractures. These injuries can cause a lot of pain and a loss of independence for older women, so it is important for doctors to understand them better.

As part of a larger study, these authors studied foot or ankle fractures in about 600 older, caucasian women. As expected, the foot fractures seemed to be caused most often by osteoporosis. Foot fractures most often happened in the fifth metatarsal (the main bone that forms the small toe), although the researchers didn't know why this was true. Women with foot fractures were also more likely to have had a fracture earlier in life.

Ankle fractures, however, did not seem to be related to osteoporosis. Ankle fractures were most often in the fibula bone (the thin bone that runs from the knee to the ankle next to the shin bone). This fracture tended to happen in younger, more active, and heavier women. The authors suggest that obesity may give extra force to accidental ankle twists. Also, the women who broke their ankles reported problems of falling more often. The authors note that increased weight may make falls more likely.

The authors also considered other factors. Diabetes can cause fractures from osteoporosis. This study showed only a slight relationship between diabetes and fractures. Also, a class of anti-anxiety and sleep medications called benzodiazepines seemed to be related to foot fractures, although the authors don't know why.

Future research from this osteoporosis study will focus on the kind of falls that cause foot and ankle fractures. This study may yet answer some of the questions about why and how older women break the bones of the foot and ankle.

References:
Carl T. Hasselman, MD, et al. Foot and Ankle Fractures in Elderly White Women. In The Journal of Bone and Joint Surgery. May 2003. Vol. 85-A. No. 5. Pp. 820-824.

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